Severe head injury is a leading cause of death and disability among young adults. Technological advances have increased the survival rate of traumatic head injury such that an increasing number survive with disabilities. There is a paucity of data in the United States documenting the long-term, that is five years or longer, aftermath of head trauma based on large civilian populations. The proposed retrospective cohort study is designed to describe the long- term quality of life of adults who have sustained and survived a traumatic head injury and also to examine several classes of predictors of these outcomes. Medical record reviews and face to face interviews will be conducted with adults who survived a traumatic head injury and were in- patients at a large rehabilitation hospital near Pittsburgh, PA in the years 1974 to 1989. This would involve 7-22 years of follow-up on these patients. Specifically we aim to: 1. Describe the long-term quality of life of moderate/severe head injury in adults. 2. Determine the influence of sociodemographic and medical factors at the time of injury on long-term quality of life for moderate/severe head injury in adults. 3. Determine predictors of mortality of moderate or severe head injured adults who have survived the initial head injury. 4. Establish a cohort of head-injured adults for future follow-up with additional funding. It is believed that this study will advance our understanding of long-term sequelae of moderate/severe head injury in adults and assist in planning resources and policies for this population.